Dental hypoplasia is a disease of tooth enamel development. Enamel is the hardest outer layer of the tooth that protects it from bacteria and chewing forces.
This anomaly occurs during tooth development and is detected by stains and small holes in the teeth.
Dental hypoplasia is a pathology that we must treat to restore the anatomy, color and function of the tooth, thus protecting it from caries and dental wear and restoring its esthetics. The enamel of our teeth does not regenerate by itself, but in this article we will discuss what treatment options are available to combat hypoplasia and restore full functionality of the teeth.
Why does dental hypoplasia occur?
Dental hypoplasia occurs in teeth that have less enamel mineralization before birth, and can affect both baby teeth and permanent teeth.
This situation usually originates from some pathology during pregnancy or childhood, such as:
- Congenital enamel hyperplasia: problems in the formation of dental enamel are usually caused by an inherited pathology called amelogenesis imperfecta, which can appear in the patient by itself congenitally or as part of some syndromes and autoimmune diseases that affect other parts of the body.
- Developmental problems in pregnancy: some prenatal situations can also affect the baby with dental hypoplasia, such as maternal vitamin D deficiency during pregnancy, premature delivery or underweight at birth.
- Developmental problems in childhood: in other cases, the pathology may be caused by deficiencies that occur during childhood and tooth formation: deficiencies of calcium, vitamins A, C or D, celiac disease or even as a consequence of some trauma to the teeth.
Early detection of dental hypoplasia is essential to treat it and thus protect the remaining enamel. Thus, it is important to visit a pediatric dentist periodically from the appearance of the first baby tooth and later a dentist specializing in prevention.
Signs of dental hypoplasia
Dental hypoplasia causes weaker or thinner enamel, making teeth more vulnerable to decay and trauma. They can appear in any tooth, but are most frequently manifested in the incisors.
The main signs of this enamel deficiency are usually:
- Dental erosions: they appear as small holes, cavities and fissures.
- Stains on the teeth: depending on the degree of severity of the dental hypoplasia, the color of these stains varies from small chalky white spots in the mildest cases, to yellowish or even brownish spots in the most severe cases.
- Dental sensitivity: the patient will present pain or sensitivity to heat and cold and also to acidic foods such as citrus fruits, since the layer underneath the enamel (dentin) is more fragile and spongy.
When dental hypoplasia is very mild, the symptoms will not be easily detectable by the patient. The problem is usually identified when dental stains or erosions appear.
Treatments for dental hypoplasia
Depending on the pathology, specialists in pediatric dentistry and dental restoration will recommend the following treatments.
Treatments for baby teeth
- Dental sealing and fluoridation: dental sealing consists of covering dental unevenness or small fissures in baby teeth with a biocompatible resin material (composite), smoothing the surface of the tooth and preventing the accumulation of food and consequent cavities. This treatment is recommended in cases with mild dental hypoplasia, in which there is little erosion of the enamel and the stains are very little visible. It is combined with fluorides to remineralize the enamel and strengthen it against caries and occlusal forces. It is usually recommended to perform these treatments in combination and periodically to keep the dental structure of children in good condition.
- Composite (resin) reconstructions: These are performed on those milk teeth that have suffered greater erosion. The treatment is based on covering the lost enamel with composite. It is combined with fluorinations to strengthen the remaining enamel. Ceramics are not used to restore temporary teeth because of their small structure and because they will be replaced by permanent teeth.
Treatments for permanent teeth
- Composite (resin) reconstructions: These are performed to reconstruct those definitive teeth that suffer small erosions, since resin is a less resistant material than ceramic and if the erosion is large it will be insufficient to withstand the forces of occlusion in the long term. Prior to reconstructing the tooth, the base will be prepared so that it is uniform. Fluorizations will always be complementary treatments that will help to strengthen (mineralize) the remaining enamel.
- Ceramic restorations: When dental hypoplasia is more advanced and the erosion of the tooth is more significant, it will be recommended to restore the tooth with ceramic structures, a more resistant material than composite. In the anterior teeth, thin veneers, usually dental veneers, will be chosen if the erosion is medium, whereas if the erosion is significant, dental caps (also known as dental crowns) will be chosen, which will embrace the entire tooth.
In posterior teeth, if the wear is medium, inlays, ceramic blocks that will cover the lost gap, will be used. If the wear is significant, we will opt for dental caps or crowns.
With ceramic restorations we achieve excellent results in the most severe cases, rehabilitating teeth with dark stains, pits and irregular tooth surfaces and restoring a harmonious and reinforced smile to the patient.
- Teeth whitening: teeth whitening treatment will be aimed at improving dental esthetics, in order to maintain a uniform appearance of the shade of the teeth. It consists of applying a whitening gel to the teeth and making it penetrate through an LED lamp. It is indicated in cases of mild dental hypoplasia that has caused stains on the teeth.
Hypoplasia treated with incisor reconstructions
Why is it so important to control dental hypoplasia?
Dental hypoplasia affects tooth enamel permanently, exposing it to food acids and occlusal forces. To avoid further deterioration of the remaining enamel, it will be very important to treat it in time and maintain good dental health:
- Hygiene habits: maintain a good oral-dental routine with tooth brushing after every meal, and the use of dental floss and interproximal brushes at least once a day. It is essential to do it correctly, so here are some tips for brushing your teeth that can help you.
- Balanced and low-sugar diet: reduce the consumption of sugars and avoid acidic and sugary drinks.
- Periodic check-ups at a dental clinic: as we have already mentioned, the symptoms of hypoplasia are sometimes not very visible until the erosion of the enamel is already significant. For this reason, regular dental check-ups and the follow-up of prevention plans are essential to keep this pathology under control and avoid its damage.
With regular checkups it is very important to always go to first level specialists, in our dental clinic our doctors will advise you if you have problems in your enamel.